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Senior Contract Manager
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- Responsible for providing education of internal MedStar Health staff on managed care, provider credentialing and enrollment, and other applicable areas for which staff require education, via Managed Care Basics or other special training seminars, Managed Care Forums & IDX User Group Presentations.
- Develops strategies to increase managed care utilization of various services in conjunction with clinical administrators and medical staff (oncology, rehabilitation, ambulatory surgery, cardiac surgery, burn services, women's services, etc
- Establishes and implements MedStar Audit requirements for Health Plans requesting HEDIS, risk adjustment, or other medical record audits and acts as liaison with MedStar entities to facilitate compliance.
- Serves as a key member of the interdisciplinary team (physicians, finance, and administrators) in the development of package pricing rates for various services (i.e. cardiac surgery, heart transplant, site-specific radiation therapy, cardiac rehabilitation, joint replacements, etc.)
- MBA, MHS or other graduate degree with a health care concentration preferred
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